Clinical Review Nurse-Prior Authorization at Centene

This role is designed for Licensed Practical Nurses (LPNs) with 2–4 years of experience who are looking to transition away from the bedside and into utilization management. The "Duals team" focuses on members with both Medicare and Medicaid coverage, so candidates with a background in outpatient services—specifically imaging, durable medical equipment (DME), or home health—will be the most competitive. The position offers significant flexibility as a fully remote role with standard business hours (8:00 AM – 5:00 PM), though you should be prepared for occasional weekend or on-call rotations. Beyond the hourly pay, the package includes comprehensive benefits like a stock purchase plan, tuition reimbursement, and 401k matching, making it a stable career move within a major national health organization. **You might be a good fit if you...** * Hold an active LPN license and have at least 2 years of clinical experience. * Have a sharp eye for medical necessity and "by-the-book" regulatory compliance. * Are comfortable navigating health management systems to document clinical findings. * Enjoy collaborating with healthcare providers to coordinate member care and discharge plans.